Fine-tuning chemotherapy in the era of dual HER2 targeting
Mené aux Pays-Bas sur 438 patientes atteintes d'un cancer du sein HER2+ de stade II-III, cet essai de phase III évalue l'efficacité, du point de vue de la proportion de patientes obtenant une réponse complète, et la toxicité (durée médiane de suivi : 19 mois) de l'ajout d'anthracyclines à un traitement néoadjuvant combinant carboplatine, taxane ainsi que trastuzumab et pertuzumab
The understanding of HER2 as a crucial oncogenic target in a subset of breast cancers and the development of HER2-targeted agents, in particular trastuzumab, has led to much optimism for patients diagnosed with HER2-positive breast cancer. A focus now is to develop regimens for patients with early-stage disease that can effectively maximise the chance of favourable outcomes but are also associated with fewer medically and functionally substantial long-term side-effects. Traditionally, drug development in breast cancer has escalated regimens by adding newer drugs to standard-of-care regimens, which, in the case of breast cancer, is polychemotherapy. A better understanding of the oncogenic target coupled with the development of synergistic agents such as trastuzumab and pertuzumab creates the setting in which we are potentially able to reduce or remove some of the conventional elements of cytotoxic chemotherapy that we as breast cancer physicians have used for many years.
The Lancet Oncology , commentaire, 2017